30 August, 2006
Council members 2006-7
Honorary President - Dr John Clark
President - Mr David Ritchie
Past President - Dr Philip Wilson
Senior Vice President - Dr Richard Watson
Honorary Treasurer - Dr Liam McKean
Honorary Secretary - Dr Duncan MacIntyre
Editorial Secretary - Dr Jonathan Oates
President - Mr David Ritchie
Past President - Dr Philip Wilson
Senior Vice President - Dr Richard Watson
Honorary Treasurer - Dr Liam McKean
Honorary Secretary - Dr Duncan MacIntyre
Editorial Secretary - Dr Jonathan Oates
Syllabus 2006-7: Session 162
Thursday September 14th, 2006 7.30pm (note change of date and time)
Council meeting
Conference Room, Floor E, Victoria Infirmary
Friday September 8th, 2006 from 2pm
Golf Outing - Bonnyton Golf Club
Thursday October 12th, 2006
Presidential Address 'Casualty to Emergency Medicine'
Mr David Ritchie
Thursday October 26th, 2006
Annual dinner
Sherbrooke Castle Hotel, Pollokshields
Thursday November 23rd, 2006
Symposium Pandemic flu – what would it mean for you?
Friday December 1st, 2006
Members of the society are invited to the Annual Christmas Dinner of the Royal Medico-Chirurgical Society – details to follow.
Thursday January 18th, 2007
'Does everyone have an autistic syndrome?'
Professor Christopher Gillberg

Christopher Gillberg, (b. 1950) is Professor of Child and Adolescent Psychiatry at Gothenburg University in Gothenburg, Sweden, and at the medical college of St George's, University of London in Tooting in south London. He has also been a visiting professor at the universities of Bergen, New York, Odense, and San Fransisco
Gillberg is known for his research of autism in children, Asperger syndrome. ADHD and anorexia nervosa. He is the founding editor of the journal European Child & Adolescent Psychiatry, and is the author and editor of many scientific and educational books. He is the recipient of several scientific awards, including the Philips Nordic Prize 2004 for neurological research, and he has more than 300 scientific papers listed in Medline. more...
Thursday February 22nd, 2007
'Glasgow's health priorities – where now?'
Dr Harry Burns

Harry Burns graduated in medicine from the University of Glasgow in 1974. Over the next 15 years he worked as a general surgeon and for the last six years of his surgical career was a consultant surgeon at the Royal Infirmary in Glasgow.
He entered health care management and was, for a time, Medical Director of the Royal Infirmary in Glasgow. Since 1993 he has been Director of Public Health for Greater Glasgow Health Board which is responsible for organising health care and maintaining the health of one million people in the West of Scotland. In 1999 he was awarded a Visiting Professorship in Public Health Medicine, University of Glasgow and is a Senior Research Fellow in the School of Business and Management in the University.
He took up post as Chief Medical Officer for Scotland on 5 September 2005.
Thursday March 8th, 2007
Honorary Presidential Address 'Forensics'
Dr John Clark
Thursday April 26th, 2007
Annual General Meeting
Conference Room, Floor E, Victoria Infirmary
Council meeting
Conference Room, Floor E, Victoria Infirmary
Friday September 8th, 2006 from 2pm
Golf Outing - Bonnyton Golf Club
Thursday October 12th, 2006
Presidential Address 'Casualty to Emergency Medicine'
Mr David Ritchie
Thursday October 26th, 2006
Annual dinner
Sherbrooke Castle Hotel, Pollokshields
Thursday November 23rd, 2006
Symposium Pandemic flu – what would it mean for you?
Friday December 1st, 2006
Members of the society are invited to the Annual Christmas Dinner of the Royal Medico-Chirurgical Society – details to follow.
Thursday January 18th, 2007
'Does everyone have an autistic syndrome?'
Professor Christopher Gillberg

Christopher Gillberg, (b. 1950) is Professor of Child and Adolescent Psychiatry at Gothenburg University in Gothenburg, Sweden, and at the medical college of St George's, University of London in Tooting in south London. He has also been a visiting professor at the universities of Bergen, New York, Odense, and San Fransisco
Gillberg is known for his research of autism in children, Asperger syndrome. ADHD and anorexia nervosa. He is the founding editor of the journal European Child & Adolescent Psychiatry, and is the author and editor of many scientific and educational books. He is the recipient of several scientific awards, including the Philips Nordic Prize 2004 for neurological research, and he has more than 300 scientific papers listed in Medline. more...
Thursday February 22nd, 2007
'Glasgow's health priorities – where now?'
Dr Harry Burns

Harry Burns graduated in medicine from the University of Glasgow in 1974. Over the next 15 years he worked as a general surgeon and for the last six years of his surgical career was a consultant surgeon at the Royal Infirmary in Glasgow.
He entered health care management and was, for a time, Medical Director of the Royal Infirmary in Glasgow. Since 1993 he has been Director of Public Health for Greater Glasgow Health Board which is responsible for organising health care and maintaining the health of one million people in the West of Scotland. In 1999 he was awarded a Visiting Professorship in Public Health Medicine, University of Glasgow and is a Senior Research Fellow in the School of Business and Management in the University.
He took up post as Chief Medical Officer for Scotland on 5 September 2005.
Thursday March 8th, 2007
Honorary Presidential Address 'Forensics'
Dr John Clark
Thursday April 26th, 2007
Annual General Meeting
Conference Room, Floor E, Victoria Infirmary
05 August, 2006
Autumn events - advance notice
Friday 8th September - Golf outing
Starts at 2pm at Bonnyton Golf Club. The usual trophies are to be won, but the important thing is to come and enjoy the afternoon. Booked for 16 only. £42 includes the round and high tea afterwards.
Thursday 12th October - Presidential Address
Our President this year is Mr David Ritchie, Consultant in Accident & Emergency.
Thursday 26th October - Annual Dinner
Again at the Sherbrooke Hotel. The recent tradition of musical entertainment to enhance the evening will continue.
Starts at 2pm at Bonnyton Golf Club. The usual trophies are to be won, but the important thing is to come and enjoy the afternoon. Booked for 16 only. £42 includes the round and high tea afterwards.
Thursday 12th October - Presidential Address
Our President this year is Mr David Ritchie, Consultant in Accident & Emergency.
Thursday 26th October - Annual Dinner
Again at the Sherbrooke Hotel. The recent tradition of musical entertainment to enhance the evening will continue.
07 March, 2006
Notice of meeting: Clinical trials in the 21st Century
Thursday 23rd March, 2006
"Clinical trials in the 21st Century"
Clinical trials are the foundation of evidence-based medicine but trialists, particularly those conducting non-commercial trials, face many challenges today.

Professor Janet Darbyshire
Director, MRC Clinical Trials Unit
Buffet supper 6.15 for 7.00pm
Ebenezer Duncan Centre, Victoria Infirmary, Glasgow
If you are a member of the Society and you would like to book for the pre-meeting buffet, please email 'Buffet' and your name to: Lesley.O'Donnell@gvic.scot.nhs.uk
"Clinical trials in the 21st Century"
Clinical trials are the foundation of evidence-based medicine but trialists, particularly those conducting non-commercial trials, face many challenges today.

Professor Janet Darbyshire
Director, MRC Clinical Trials Unit
Buffet supper 6.15 for 7.00pm
Ebenezer Duncan Centre, Victoria Infirmary, Glasgow
If you are a member of the Society and you would like to book for the pre-meeting buffet, please email 'Buffet' and your name to: Lesley.O'Donnell@gvic.scot.nhs.uk
28 February, 2006
Family Research Matters - audience discussion
Part 2 of Family Research Matters. This recording is of the audience discussion following Prof Graham Watt's lecture given to The Glasgow Southern Medical Society on Thursday 23rd February 2006.
Listen again:
Download [ mp3] 11.2Mb
Listen to [streaming audio]
Listen again:
Download [ mp3] 11.2Mb
Listen to [streaming audio]
26 February, 2006
Family Research Matters
Will new developments in genetics render more traditional population studies redundant? How do disease patterns in the West of Scotland differ from those in other developed nations? Why do health behaviour patterns of your parents influence your health later in life? These and other questions are addressed by Prof Graham Watt, Professor of General Practice in his Honorary Presidential Lecture to The Glasgow Southern Medical Society.
Listen again:
Download [ mp3] 32.3Mb
Listen to [streaming audio]
View slides as pdf
Further reading:
tags: epidemiology medicine primary care behaviour behavior
Listen again:
Download [ mp3] 32.3Mb
Listen to [streaming audio]
View slides as pdf
Further reading:
tags: epidemiology medicine primary care behaviour behavior
10 February, 2006
Notice of meeting: Honorary Presidential Address 'Family matters'
You are cordially invited to attend the meeting:
'Family matters' - the new genetics

Speaker: Prof Graham Watt, University of Glasgow
Date and time: Thursday 23rd February 2006 at 7.00pm
Venue: Ebenezer Duncan Centre, The Victoria Infirmary, Glasgow
This meeting is open to all medical, nursing and paramedical staff.
If you are a member of the Society and you would like to book for the pre-meeting buffet, please email 'Buffet' and your name to: Lesley.O'Donnell@gvic.scot.nhs.uk
Please note that the lecture and subsequent discussion will be recorded for later publication on the Society's website.
'Family matters' - the new genetics

Speaker: Prof Graham Watt, University of Glasgow
Date and time: Thursday 23rd February 2006 at 7.00pm
Venue: Ebenezer Duncan Centre, The Victoria Infirmary, Glasgow
This meeting is open to all medical, nursing and paramedical staff.
If you are a member of the Society and you would like to book for the pre-meeting buffet, please email 'Buffet' and your name to: Lesley.O'Donnell@gvic.scot.nhs.uk
Please note that the lecture and subsequent discussion will be recorded for later publication on the Society's website.
09 February, 2006
100 years ago: Session 1905-06; Meeting VIII - The surgical treatment of Senile Hypertrophy of the Prostate
The Society met in the rooms of the Medical Club, 22 Carlton Place on Thursday 25th January 1906 at 9pm.
Sederunt
In the absence of the President, Dr T.K. Monro (Vice-President) took the chair and in all 16 gentlemen were present.
Minutes
The minutes of the last meeting were read and approved of.
Correspondence
Three letters were read. 1st from the Secretary of the Eastern Medical Society inviting members to be present at their dance on Feb 8th - In reply to this it was stated that the Smoking Concert of this Society fell on the same evening & therefore this invitation could not be accepted.
2nd from Dr Stockman (President) calling an extraordinary meeting of the Society for Thursday Feb 1st to hear a paper by Dr Mason. This was on the requisition of 3 members viz. Dr Richmond, T.K. Monro & R.W. Forrest.
3rd a letter from Mr W.B. Taylor representing Messers Burroughs Welcome & Co promising to give a display of their products on Feb 22nd.
New Members
On the motion of the Chairman the Standing orders were suspended and Dr Farquhar MacRae 256 Bath St was admitted a member.
Death of Dr Duncan McGilvray
The chairman then referred to the death of Dr Duncan McGilvray, a former president of this Society, and said that the Society had sustained a very great loss. He had been for long a prominent member of the Society and his connection with all the social functions of the Society and of the Medical Club were always of a most genial & generous nature. He also reported that at a special joint meeting of the Council of the Society and of the Committee of the Medical Club which was held on the 23rd January a deputation consisting of Dr T.K. Monro (vice president) with the Secretary & Treasurer had been appointed to attend the funeral as representatives of the Society. This was done by the deputation on the 24th January. It was then agreed that the President and Secretary be asked to communicate the sympathy felt by the Society to Dr McGilvray's mother.
Dr J.H. Nicoll's Paper
Dr James H. Nicoll then read a paper on:
"The surgical treatment of Senile Hypertrophy of the Prostate", and showed some instruments, pathological specimens, and lantern slides in illustration of his remarks. The paper was enlivened by a vigorously stated protest against the claims advanced by Mr Freyer of London that he had devised an original operation for enucleation of the prostate. At the Close of the paper Drs T.K. Monro, Richmond, Stewart, Peden, James Russell & J.P. Duncan took part in a short discussion mainly of a complimentary nature on the paper and a few questions were asked. Dr Nicoll then replied very briefly and was awarded hearty applause.
This was all the business.
Precis of Dr Nicoll's paper
He states that:
Senile hypertrophy is an adenoma or adeno-myoma & affects a large proportion of men over fifty, but only in a comparatively small number calls for treatment. The treatment is medicinal, mechanical or operative. Despite all that has recently been said by Freyer & others no new facts have been added to our knowledge of the treatment of senile prostate within the past decade.
But with a mortality of 5% still falling, prostatectomy is gradually relegating the catheter to the role of the truss in hernia, viz. the relief of inoperable cases.
So far as the technique of prostatectomy goes, the operation is an enucleation of the prostate from its capsule by use of the finger. This is the modern operation & is the same operation exactly at the present date as was in the early nineties.
Ralph Stockman.
Archive: Royal College of Physicians and Surgeons of Glasgow
Reference: GB 250 RCPSG 73/1/11 Minute Book No. 6
Sederunt
In the absence of the President, Dr T.K. Monro (Vice-President) took the chair and in all 16 gentlemen were present.
Minutes
The minutes of the last meeting were read and approved of.
Correspondence
Three letters were read. 1st from the Secretary of the Eastern Medical Society inviting members to be present at their dance on Feb 8th - In reply to this it was stated that the Smoking Concert of this Society fell on the same evening & therefore this invitation could not be accepted.
2nd from Dr Stockman (President) calling an extraordinary meeting of the Society for Thursday Feb 1st to hear a paper by Dr Mason. This was on the requisition of 3 members viz. Dr Richmond, T.K. Monro & R.W. Forrest.
3rd a letter from Mr W.B. Taylor representing Messers Burroughs Welcome & Co promising to give a display of their products on Feb 22nd.
New Members
On the motion of the Chairman the Standing orders were suspended and Dr Farquhar MacRae 256 Bath St was admitted a member.
Death of Dr Duncan McGilvray
The chairman then referred to the death of Dr Duncan McGilvray, a former president of this Society, and said that the Society had sustained a very great loss. He had been for long a prominent member of the Society and his connection with all the social functions of the Society and of the Medical Club were always of a most genial & generous nature. He also reported that at a special joint meeting of the Council of the Society and of the Committee of the Medical Club which was held on the 23rd January a deputation consisting of Dr T.K. Monro (vice president) with the Secretary & Treasurer had been appointed to attend the funeral as representatives of the Society. This was done by the deputation on the 24th January. It was then agreed that the President and Secretary be asked to communicate the sympathy felt by the Society to Dr McGilvray's mother.
Dr J.H. Nicoll's Paper
Dr James H. Nicoll then read a paper on:
"The surgical treatment of Senile Hypertrophy of the Prostate", and showed some instruments, pathological specimens, and lantern slides in illustration of his remarks. The paper was enlivened by a vigorously stated protest against the claims advanced by Mr Freyer of London that he had devised an original operation for enucleation of the prostate. At the Close of the paper Drs T.K. Monro, Richmond, Stewart, Peden, James Russell & J.P. Duncan took part in a short discussion mainly of a complimentary nature on the paper and a few questions were asked. Dr Nicoll then replied very briefly and was awarded hearty applause.
This was all the business.
Precis of Dr Nicoll's paper
He states that:
Senile hypertrophy is an adenoma or adeno-myoma & affects a large proportion of men over fifty, but only in a comparatively small number calls for treatment. The treatment is medicinal, mechanical or operative. Despite all that has recently been said by Freyer & others no new facts have been added to our knowledge of the treatment of senile prostate within the past decade.
But with a mortality of 5% still falling, prostatectomy is gradually relegating the catheter to the role of the truss in hernia, viz. the relief of inoperable cases.
So far as the technique of prostatectomy goes, the operation is an enucleation of the prostate from its capsule by use of the finger. This is the modern operation & is the same operation exactly at the present date as was in the early nineties.
Ralph Stockman.
Archive: Royal College of Physicians and Surgeons of Glasgow
Reference: GB 250 RCPSG 73/1/11 Minute Book No. 6
11 January, 2006
100 years ago: Session 1905-06; Meeting VII - The Treatment of Gonorrhoea and its Complications
The Society met in the rooms of the Medical Club 22 Carlton Place on Thursday 11th January 1906 at 9pm.
Sederunt
The President (Dr Stockman) was in the chair, and in all 15 gentlemen were present.
Minutes
In the absence of the Secretary, who was ill, the Treasurer Dr R. W. Forrest read the minutes of last meeting & these were approved.
New Members
The Standing orders were suspended & Dr Robert Taylor Beechwood, Dalkeith Avenue, Dumbreck was admitted a member. The name of Dr Farquhar MacRae, 256 Bath St, was proposed for membership by Dr R. T. Halliday & seconded by Dr J. P. Duncan.
Professional Conversation
A professional conversation on the subject: "The treatment of Gonorrhoea and its complications" then took place. Dr James Weir opened the discussion and confined his remarks to Specific Urethritis. Cases got in the early stage with a watery discharge, and treated with injections of solution of 20 grains of silver nitrate to the ounce were frequently aborted.
Dr Achd Young advocated the use of Salol & 10gr doses of Urotropine. Dr Halliday used Urotropine & Methylene Blue. Dr Wauchope after a general statement of his views on the pathology of the disease recommended rest in bed & barley water as a suitable treatment. These views did not seem to be generally acceptable to the members present.
Dr C. E. Robertson gave a clear exposition of the methods of treatment he adopted in his own practice and advocated the use of Hewlets mixture of cubebs & Santal oil. Dr W. K. Peden advocated the use of urotropine and of lavage of the distal 6 inches of the urethra several times a day & cited cases in which it had worked well & said that in later stages 4grs to the ounce of Silver nitrate solution was to be used.
The President then made some remarks & summed up the matter gone over in a general way.
Dr C. E. Robertson on the political question
Dr C. E. Robertson then introduced an informal discussion on the attitude of members of the Society with regard to medical matters in the present political campaign and suggested that questions to be put to the candidates might be formulated. However after some discussion it was pointed out that notice of motion should have been given & the matter dropped.
This was all the business.
T. K. Monro
Archive: Royal College of Physicians and Surgeons of Glasgow
Reference: GB 250 RCPSG 73/1/11 Minute Book No. 6
Further reading
Salol
Grains (measure)
Urotropine
Cubebs
Santal oil
UK general election 1906
Sederunt
The President (Dr Stockman) was in the chair, and in all 15 gentlemen were present.
Minutes
In the absence of the Secretary, who was ill, the Treasurer Dr R. W. Forrest read the minutes of last meeting & these were approved.
New Members
The Standing orders were suspended & Dr Robert Taylor Beechwood, Dalkeith Avenue, Dumbreck was admitted a member. The name of Dr Farquhar MacRae, 256 Bath St, was proposed for membership by Dr R. T. Halliday & seconded by Dr J. P. Duncan.
Professional Conversation
A professional conversation on the subject: "The treatment of Gonorrhoea and its complications" then took place. Dr James Weir opened the discussion and confined his remarks to Specific Urethritis. Cases got in the early stage with a watery discharge, and treated with injections of solution of 20 grains of silver nitrate to the ounce were frequently aborted.
Dr Achd Young advocated the use of Salol & 10gr doses of Urotropine. Dr Halliday used Urotropine & Methylene Blue. Dr Wauchope after a general statement of his views on the pathology of the disease recommended rest in bed & barley water as a suitable treatment. These views did not seem to be generally acceptable to the members present.
Dr C. E. Robertson gave a clear exposition of the methods of treatment he adopted in his own practice and advocated the use of Hewlets mixture of cubebs & Santal oil. Dr W. K. Peden advocated the use of urotropine and of lavage of the distal 6 inches of the urethra several times a day & cited cases in which it had worked well & said that in later stages 4grs to the ounce of Silver nitrate solution was to be used.
The President then made some remarks & summed up the matter gone over in a general way.
Dr C. E. Robertson on the political question
Dr C. E. Robertson then introduced an informal discussion on the attitude of members of the Society with regard to medical matters in the present political campaign and suggested that questions to be put to the candidates might be formulated. However after some discussion it was pointed out that notice of motion should have been given & the matter dropped.
This was all the business.
T. K. Monro
Archive: Royal College of Physicians and Surgeons of Glasgow
Reference: GB 250 RCPSG 73/1/11 Minute Book No. 6
Further reading
Salol
Grains (measure)
Urotropine
Cubebs
Santal oil
UK general election 1906
24 December, 2005
100 years ago: Session 1905-06; Meeting VI - Uterine myoma
The Society met in the rooms of the Medical Club, 22 Carlton Place on Thursday 14th December 1905 at 9pm.
Sederunt
Dr T. K. Monro (Vice-President) in the chair: in all 18 Gentlemen were present.
Minutes
The minutes of last meeting were read and approved.
New Member
The name of Dr Robert Taylor, Beechwood, Dalkeith Avenue Dumbreck, was proposed for membership by Dr James Hamilton & seconded by Dr J. P. Duncan.
Dr J. K. Kelly's paper
Dr J. K. Kelly then read a most interesting paper on "Uterine Myoma" & this was followed by a lantern demonstration of various pathological specimens in connection with the subject. A precis of Dr Kelly's Paper follows this minute.
A discussion followed in which Drs T. K. Monro, Stark, James Weir, Miller, Hamilton & Wauchope took part, asking for further information on several points and Dr Hamilton stated that he could not see why oophorectomy for the treatment of myomata should be condemned. Dr Kelly replied that he was of the opinion that it was better to remove the disease than to remove the ovaries alone then wait for a somewhat doubtful cure.
Dr Kelly was accorded a very hearty vote of thanks for his paper.
This was all the business.
Precis of Dr J. K. Kelly's paper
Dr Kelly referred first to the question of the division of tumours into Benign & Malignant & went on to state that some "benign" tumours can destroy life just as surely as Malignant ones, and Uterine myomata were one of this serious nature in many cases. The ordinary Symptomatology of the disease was then given, & it was insisted strongly that Uterine Myomata sometimes produced no symptoms except that of haemorrhage: & that even when a large tumour was present the patient had not noticed it. Pain in the case of this disease is a very variable symptom. The case of a woman 5 months pregnant was then cited in which a myoma as large as a small cocoa-nut was removed from the Uterine wall: cessaton of pain followed & the gestation & delivery were normal.
The dangers associated with Uterine Myomata were stated as follows:
1. Haemorrhage, producing syncope, anaemia & its consequences
2. Certain Cardiac conditions are induced in bad cases.
3. Renal disease from 1. Retention of urine followed by cystitis & 2. obstruction to Ureters.
4. Adhesions especially when Salpingitis is also present.
5. In Pregnancy 1. may necessitate Craniotomy or Caesarian Section 2. May induce rupture of Uterus 3. May induce post partum haemorrhage 4. May contribute to sepsis.
If Operation be called for from the interference from pressure effects on abdominal, thoracic, or pelvic structures Dr Kelly is of opinion that hysterectomy is as a rule safer than the induction of labour. With regard to the coincidence of pregnancy & myomata the remarkable crushing & moulding of tumour or foetus that is sometimes met with was referred to, & in such cases delivery sometimes takes place naturally in spite of the obstruction.
The comparative safety of Caesarian Section & Hysterectomy nowadays, has, however, altered the position of the Gynaecologist with regard to the treatment of such cases; and indeed now-a-days there are few myomata that cannot be treated with success if treatment be demanded. Dr Kelly then stated three typical cases of women with Uterine Myomata at various stages of development & stated the case for & against operation in each case, & then proceeded to state the principles that guided him in his own practice, viz: He advocates removal of the Myomata if
1. It causes Haemorrhage 2. if it be large even if symptoms are slight 3. if it be degenerated in any way or if disease of the adnexa are present, 4. If it is injuring the health of the patient in any way even if the menopause is not far off.
A proviso is made that the earlier the tumour can be removed the safer is the operation & the better is the condition of the patient afterwards.
The operative measures that may be adopted were dealt with.
1. Myomectomy is the ideal operation especially if it may be done per vaginam.
2. Hysterectomy is necessary when myomectomy is not practical.
3. Oophorectomy is to be reserved for cases where the number & size of the adhesions present contraindicate either of the first two methods.
If operation is refused palliative measures must be adopted eg haemorrhage & pressure symptoms must be treated.
Ralph Stockman
Archive: Royal College of Physicians and Surgeons of Glasgow
Reference: GB 250 RCPSG 73/1/11 Minute Book No. 6
Sederunt
Dr T. K. Monro (Vice-President) in the chair: in all 18 Gentlemen were present.
Minutes
The minutes of last meeting were read and approved.
New Member
The name of Dr Robert Taylor, Beechwood, Dalkeith Avenue Dumbreck, was proposed for membership by Dr James Hamilton & seconded by Dr J. P. Duncan.
Dr J. K. Kelly's paper
Dr J. K. Kelly then read a most interesting paper on "Uterine Myoma" & this was followed by a lantern demonstration of various pathological specimens in connection with the subject. A precis of Dr Kelly's Paper follows this minute.
A discussion followed in which Drs T. K. Monro, Stark, James Weir, Miller, Hamilton & Wauchope took part, asking for further information on several points and Dr Hamilton stated that he could not see why oophorectomy for the treatment of myomata should be condemned. Dr Kelly replied that he was of the opinion that it was better to remove the disease than to remove the ovaries alone then wait for a somewhat doubtful cure.
Dr Kelly was accorded a very hearty vote of thanks for his paper.
This was all the business.
Precis of Dr J. K. Kelly's paper
Dr Kelly referred first to the question of the division of tumours into Benign & Malignant & went on to state that some "benign" tumours can destroy life just as surely as Malignant ones, and Uterine myomata were one of this serious nature in many cases. The ordinary Symptomatology of the disease was then given, & it was insisted strongly that Uterine Myomata sometimes produced no symptoms except that of haemorrhage: & that even when a large tumour was present the patient had not noticed it. Pain in the case of this disease is a very variable symptom. The case of a woman 5 months pregnant was then cited in which a myoma as large as a small cocoa-nut was removed from the Uterine wall: cessaton of pain followed & the gestation & delivery were normal.
The dangers associated with Uterine Myomata were stated as follows:
1. Haemorrhage, producing syncope, anaemia & its consequences
2. Certain Cardiac conditions are induced in bad cases.
3. Renal disease from 1. Retention of urine followed by cystitis & 2. obstruction to Ureters.
4. Adhesions especially when Salpingitis is also present.
5. In Pregnancy 1. may necessitate Craniotomy or Caesarian Section 2. May induce rupture of Uterus 3. May induce post partum haemorrhage 4. May contribute to sepsis.
If Operation be called for from the interference from pressure effects on abdominal, thoracic, or pelvic structures Dr Kelly is of opinion that hysterectomy is as a rule safer than the induction of labour. With regard to the coincidence of pregnancy & myomata the remarkable crushing & moulding of tumour or foetus that is sometimes met with was referred to, & in such cases delivery sometimes takes place naturally in spite of the obstruction.
The comparative safety of Caesarian Section & Hysterectomy nowadays, has, however, altered the position of the Gynaecologist with regard to the treatment of such cases; and indeed now-a-days there are few myomata that cannot be treated with success if treatment be demanded. Dr Kelly then stated three typical cases of women with Uterine Myomata at various stages of development & stated the case for & against operation in each case, & then proceeded to state the principles that guided him in his own practice, viz: He advocates removal of the Myomata if
1. It causes Haemorrhage 2. if it be large even if symptoms are slight 3. if it be degenerated in any way or if disease of the adnexa are present, 4. If it is injuring the health of the patient in any way even if the menopause is not far off.
A proviso is made that the earlier the tumour can be removed the safer is the operation & the better is the condition of the patient afterwards.
The operative measures that may be adopted were dealt with.
1. Myomectomy is the ideal operation especially if it may be done per vaginam.
2. Hysterectomy is necessary when myomectomy is not practical.
3. Oophorectomy is to be reserved for cases where the number & size of the adhesions present contraindicate either of the first two methods.
If operation is refused palliative measures must be adopted eg haemorrhage & pressure symptoms must be treated.
Ralph Stockman
Archive: Royal College of Physicians and Surgeons of Glasgow
Reference: GB 250 RCPSG 73/1/11 Minute Book No. 6
Subscribe to:
Posts (Atom)



